It is a
truth universally acknowledged that all fledgling therapists must learn how to
fly. Being an OT student forces you to have odd conversations with yourself,
stare into the mirror in deep introspection, and, most frequently
practiced (often during lectures): stare out of windows and contemplate life. A huge part of being a
student involves introspection, there's just something about being immersed in crazy that makes you wonder if you've got a little bit of that in yourself.
The first
lesson I have learnt from this fieldwork block is how much luck I've been dealt in this lifetime. Two of the four clients that I’ve worked with have been
my age. To compare the path they’ve walked to the one I’ve walked, is really
eye opening. To think, 22 years ago all three of us were in hospital cots:
small, wrinkled, innocent creatures, just waiting for life to have its way with
us. This fieldwork block has taught me gratitude. Three innocents left
hospitals 22 years ago. One became a fledgling OT, the other two smoked away
years of their lives. Cards were dealt, and mine were good. That’s luck. What
my clients have taught me is to be grateful for all the support I have around
me, for all the opportunities that lay before me, and finally, grateful that my
mind is mine to control-not tainted by a sinister substance that will forever
haunt its crevasses. A class exercise this semester had us practice
journaling what we are grateful for. I’ve carried this over to my daily
routine, and it forces me to change perspectives on my current situation- just
as this prac has forced a change in my perspectives. Having the opportunity to
work with people who’ve walked such a different path to my own has been a
blessing. So I’m also grateful to these clients, whose life lessons have become
my own, and who have forced me to acknowledge my own privilege and take time to
value the decisions that I have made in this lifetime.
The second lesson that this prac has taught me, is that I do not disclose a lot about myself to people. A lot of
this prac has involved sitting and having lengthy conversations with my clients,
which (surprisingly) has been something that I really enjoy. I’ve always been
very social but had never forged strong therapeutic relationships with clients
before. Mostly, because I went into a session ready to get the job done: tick
off my aims and move on to the next session. This fieldwork block, and
specifically this fieldwork site, does not allow for that. Psych block at a
third year level has to involve you building strong rapport with your client,
that’s essential if you’re trying to get someone to change their entire life.
So through this 8 week journey, and having all these deep conversations with my
clients, I began to open up about myself. I had to. I can’t expect someone to
tell me their whole life story without disclosing some of my own. Trust is
essential. Whilst having conversations with clients, I was shocked to realize I
would say something to them that I hadn’t said to anyone before. Frankly, this
fieldwork block has helped me realize that I may have some trust issues. Furthermore,
that I actually enjoy talking about shared experiences and using examples from
my own life during sessions- and clients appreciate that, they respond so much
better to me when I can empathize. A study by Mathews (1989) found that 90% of
therapists using psychotherapy self-disclose. Interestingly, it was believed by
Freud that the therapist should be completely neutral within the therapeutic
relationship, only acting as a mirror to the client and not sharing personal views (Freud & Strachey,
1952). Whilst those taking a humanist perspective believed that the
therapist who uses “therapy-relevant self-disclosure invites the client to
follow the lead and cultivates trust, perceived similarity, credibility, and
empathic understanding” (Kotter, 2003). The latter makes so much more sense to me, after all, we're working with people who want to feel understood. Thus,
I have discovered through fieldwork that I am a humanist.
Lastly,
this fieldwork block has solidified my own beliefs about relationships and what
value I see in them. My clients have all had fascinating relationship dynamics
throughout their lives. Even after only 22 years of life, somehow two of the
four managed to tangle themselves into nasty webs of conflict, hate and
betrayal in romantic and familial relations. Never before have I had to tread
with so much caution when conducting an interview and compiling a genogram. One
mention of the wrong name and it sets them off. All four of my clients have had
significant conflict within their closest relationships- with their families
and partners. I learnt very quickly not to assume any roles or generalize about
dynamics, these relationships were messy. Having come from a background of
divorced parents, I’m used to a change of dynamics and roles within families.
However, it was not as cut and dry for my clients. Throughout therapy I’ve had
to objectively examine the dynamics within my clients’ relationships, which was more challenging than I expected. Subsequently, I have discovered that my
expectations of relationships and the rules that I believe accompany relationships cannot
be generalized to my clients' contexts. I have a client who firmly believes in open relationships and
having more than one partner. As he is firm in his beliefs, and I in mine, this clash caused me far more distress than I expected. I became acutely aware of how much I disliked it when a client couldn't see something from my perspective, and had to actively work on my own self-control to ensure we could still maintain a successful therapeutic relationship.
Exploring relationships through the eyes of my clients has taught me
about what my boundaries are, and about my own expectations about roles and
dynamics. So whilst my clients untangled their relationship webs, I learnt how
not to get stuck in one.
Here’s a
link to a discussion about how important it is to increase awareness about your
fundamental relationship beliefs: https://www.youtube.com/watch?v=gh5VhaicC6g. This helped to reaffirm how
important it is for me to develop this awareness, so that I don't enter into the same unhealthy relationship habits as my clients.
This
fieldwork block has been an important platform for me to learn more about
myself. Working in the psychiatric field is ultimately what I want to do with
my career. As a result, I’m sure to learn a lot about my personality, my
boundaries, how I handle people and how I respond to behaviours. That is just
the nature of working in this field. Every interaction is an opportunity for
self-growth, for both my clients and me. This fieldwork block has taught me
many lessons, the most important being: I’ve made the right choice of how
to spend the rest of my life.
Until next week,
Kaylee
References:
Freud, S. & Strachey, J. (Ed.), (1952). The standard edition of the complete
psychological works of Sigmund Freud. Vol. 12. Hogarth
Press, London, pp. 97-108
Kottler, J. A. (2003). On
being a therapist. San Francisco: Jossey-Bass.
Mathews, B. (1989). The
use of therapist self-disclosure and its potential impact on the therapeutic
process. Journal of Human Behavior and Learning, 6(2), 25–29.
TedxTalks.,[Tedx]. (2015). Skills for health romantic
relationships. [Video File]. Available at: https://www.youtube.com/watch?v=gh5VhaicC6g
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